Active NPI
Adam Enoch
- Clinical Social Worker
- Middletown, CT
National Provider Identifier
1164080420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13337
- Practice address
- 33 Burgundy Hill LN
Middletown, CT 06457-6331 - Phone
- (203) 868-9943
- NPI assigned
- Jun 3, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 13337 | CT | Primary |
Addresses
Primary practice location
33 Burgundy Hill LN
Middletown, CT 06457-6331
Mailing address
33 Burgundy Hill LN
Middletown, CT 06457-6331
Phone (203) 868-9943
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13337 | CT | MD | Adult Health Nurse Practitioner |
Interoperability endpoints
- adam.enoch.p1@direct.wheelerclinic.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1164080420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 BURGUNDY HILL LN",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064576331",
"telephone_number": "203-868-9943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 BURGUNDY HILL LN",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064576331",
"telephone_number": "203-868-9943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENOCH",
"first_name": "ADAM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-03",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "13337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.